Ultrasound echomyography in facial palsy

Sauer M, Guntinas-Lichius O, Volk GF. Ultrasound echomyography of facial

muscles in diagnosis and follow-up of facial palsy in children. Eur J Paediatr

Neurol. 2016 Mar 26. pii: S1090-3798(16)00054-4. doi: 10.1016/j.ejpn.2016.03.006.

[Epub ahead of print]

Abstract

BACKGROUND:

Ultrasonography is a reliable, non-invasive and painless tool for quantitative assessment of the static and dynamic changes of the facial muscles in adult patients with facial palsy. Therefore it would also be worthwhile to establish the method for quantitative analysis of facial muscles in children with facial palsy to improve and expand the diagnostics for paediatric facial palsy.

METHODS:

Eight children, aged 1-18 years, with facial palsy of different aetiology were scanned and their ultrasound-images analysed. Bilateral scans of the frontal, orbicularis oculi, zygomaticus major, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis muscle were performed at rest and if possible during contraction. Muscle cross-section area, muscle thickness and echo intensity were measured.

RESULTS:

All muscles of our investigation protocol for adults could also be reliably identified in children. On the paralyzed side of the face a reduction of muscle size in rest and contraction and higher echo intensity could be convincingly detected. Based on these observations, we were able to make well-founded treatment decisions and avoid painful electrophysiological examinations.

CONCLUSION:

Ultrasonography of facial muscles is also feasible in children and facilitates diagnostics in children with facial palsy.

Courtesy of:  http://www.mdlinx.com/neurology/medical-news-article/2016/04/13/quantitative-sonography-children-facial-palsy-mimic/6605121/?category=sub-specialty&page_id=2&subspec_id=317

Volk GF, Pohlmann M, Sauer M, Finkensieper M, Guntinas-Lichius O. Quantitative

ultrasonography of facial muscles in patients with chronic facial palsy. Muscle

Nerve. 2014 Sep;50(3):358-65

Abstract

INTRODUCTION:

In this study we introduce quantitative facial muscle ultrasound as a diagnostic tool for patients with chronic unilateral facial palsy.

METHODS:

Muscle area, thickness, and echo intensity of 6 facial muscles (frontalis, orbicularis oculi, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis) and of 2 chewing muscles (temporalis and masseter, as controls) were measured in 20 patients with chronic facial palsy.

RESULTS:

Aside from 1, all facial muscles were significantly smaller on the paralyzed side. With exception of frontalis and orbicularis oculi muscles, all other facial muscles showed significantly higher echo intensity on the affected side. Muscle size and echo intensity of the chewing muscles showed no side-to-side asymmetry.

CONCLUSIONS:

Quantitative ultrasound of facial muscles helps to better characterize their status in patients with chronic facial palsy in the phase of denervation and during regeneration.

Volk GF, Pohlmann M, Finkensieper M, Chalmers HJ, Guntinas-Lichius O.

3D-Ultrasonography for evaluation of facial muscles in patients with chronic

facial palsy or defective healing: a pilot study. BMC Ear Nose Throat Disord.

2014 Apr 25;14:4.

Abstract

BACKGROUND:

While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking.

METHODS:

A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions.

RESULTS:

The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side.

CONCLUSION:

3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment.